Medicare Reimbursement for CPT 23412

This page covers CPT code 23412, a physician procedure code defined by the AMA (descriptor not shown here due to licensing restrictions). It presents the Medicare Physician Fee Schedule (PFS) allowed amount for this code, shown nationally and adjusted by locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$791.60	$791.60
ALASKA* (AK)	$970.66	$970.66
ALABAMA (AL)	$716.33	$716.33
ARKANSAS (AR)	$707.07	$707.07
ARIZONA (AZ)	$770.01	$770.01
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$914.51	$914.51
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$928.40	$928.40
OXNARD-THOUSAND OAKS-VENTURA (CA)	$830.85	$830.85
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$839.53	$839.53
NAPA (CA)	$879.07	$879.07
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$917.24	$917.24
VALLEJO (CA)	$875.13	$875.13
BAKERSFIELD (CA)	$798.48	$798.48
CHICO (CA)	$791.83	$791.83
FRESNO (CA)	$791.83	$791.83
HANFORD-CORCORAN (CA)	$791.83	$791.83
MADERA (CA)	$791.83	$791.83
MERCED (CA)	$791.83	$791.83
MODESTO (CA)	$791.83	$791.83
REDDING (CA)	$791.83	$791.83
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$817.74	$817.74
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$820.83	$820.83
SALINAS (CA)	$817.59	$817.59
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$939.59	$939.59
SANTA CRUZ-WATSONVILLE (CA)	$831.78	$831.78
SANTA ROSA-PETALUMA (CA)	$839.47	$839.47
STOCKTON (CA)	$791.83	$791.83
VISALIA (CA)	$791.83	$791.83
YUBA CITY (CA)	$791.83	$791.83
EL CENTRO (CA)	$792.23	$792.23
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$829.63	$829.63
SAN LUIS OBISPO-PASO ROBLES (CA)	$805.70	$805.70
SANTA MARIA-SANTA BARBARA (CA)	$818.69	$818.69
REST OF CALIFORNIA (CA)	$791.83	$791.83
COLORADO (CO)	$799.28	$799.28
CONNECTICUT (CT)	$841.12	$841.12
DC + MD/VA SUBURBS (DC)	$879.11	$879.11
DELAWARE (DE)	$781.54	$781.54
FORT LAUDERDALE (FL)	$860.84	$860.84
MIAMI (FL)	$927.91	$927.91
REST OF FLORIDA (FL)	$817.89	$817.89
ATLANTA (GA)	$814.11	$814.11
REST OF GEORGIA (GA)	$772.21	$772.21
HAWAII, GUAM (HI)	$801.92	$801.92
IOWA (IA)	$715.64	$715.64
IDAHO (ID)	$723.37	$723.37
EAST ST. LOUIS (IL)	$847.41	$847.41
SUBURBAN CHICAGO (IL)	$865.18	$865.18
CHICAGO (IL)	$900.18	$900.18
REST OF ILLINOIS (IL)	$808.85	$808.85
INDIANA (IN)	$726.67	$726.67
KANSAS (KS)	$720.70	$720.70
KENTUCKY (KY)	$748.94	$748.94
NEW ORLEANS (LA)	$783.51	$783.51
REST OF LOUISIANA (LA)	$751.12	$751.12
METROPOLITAN BOSTON (MA)	$861.27	$861.27
REST OF MASSACHUSETTS (MA)	$798.58	$798.58
BALTIMORE/SURR. CNTYS (MD)	$840.45	$840.45
REST OF MARYLAND (MD)	$792.76	$792.76
SOUTHERN MAINE (ME)	$758.99	$758.99
REST OF MAINE (ME)	$735.36	$735.36
DETROIT (MI)	$835.53	$835.53
REST OF MICHIGAN (MI)	$773.91	$773.91
MINNESOTA (MN)	$744.29	$744.29
METROPOLITAN ST. LOUIS (MO)	$776.27	$776.27
METROPOLITAN KANSAS CITY (MO)	$770.07	$770.07
REST OF MISSOURI (MO)	$744.98	$744.98
MISSISSIPPI (MS)	$725.74	$725.74
MONTANA** (MT)	$791.44	$791.44
NORTH CAROLINA (NC)	$740.92	$740.92
NORTH DAKOTA** (ND)	$743.79	$743.79
NEBRASKA (NE)	$716.69	$716.69
NEW HAMPSHIRE (NH)	$794.77	$794.77
NORTHERN NJ (NJ)	$873.17	$873.17
REST OF NEW JERSEY (NJ)	$844.63	$844.63
NEW MEXICO (NM)	$781.00	$781.00
NEVADA** (NV)	$778.48	$778.48
MANHATTAN (NY)	$915.90	$915.90
NYC SUBURBS/LONG ISLAND (NY)	$946.43	$946.43
POUGHKPSIE/N NYC SUBURBS (NY)	$856.64	$856.64
QUEENS (NY)	$910.76	$910.76
REST OF NEW YORK (NY)	$751.56	$751.56
OHIO (OH)	$764.17	$764.17
OKLAHOMA (OK)	$739.13	$739.13
PORTLAND (OR)	$813.02	$813.02
REST OF OREGON (OR)	$766.40	$766.40
METROPOLITAN PHILADELPHIA (PA)	$827.36	$827.36
REST OF PENNSYLVANIA (PA)	$760.72	$760.72
PUERTO RICO (PR)	$793.94	$793.94
RHODE ISLAND (RI)	$800.94	$800.94
SOUTH CAROLINA (SC)	$755.01	$755.01
SOUTH DAKOTA** (SD)	$738.15	$738.15
TENNESSEE (TN)	$724.97	$724.97
BRAZORIA (TX)	$774.10	$774.10
DALLAS (TX)	$782.38	$782.38
GALVESTON (TX)	$778.61	$778.61
HOUSTON (TX)	$822.72	$822.72
BEAUMONT (TX)	$756.85	$756.85
FORT WORTH (TX)	$780.20	$780.20
AUSTIN (TX)	$801.92	$801.92
REST OF TEXAS (TX)	$767.34	$767.34
UTAH (UT)	$764.03	$764.03
VIRGINIA (VA)	$762.45	$762.45
VIRGIN ISLANDS (VI)	$793.94	$793.94
VERMONT (VT)	$748.61	$748.61
SEATTLE (KING CNTY) (WA)	$869.54	$869.54
REST OF WASHINGTON (WA)	$794.51	$794.51
WISCONSIN (WI)	$722.35	$722.35
WEST VIRGINIA (WV)	$784.03	$784.03
WYOMING** (WY)	$770.67	$770.67

Look up another code or locality →

Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 1 unit per patient per day — Date of Service Edit: Policy. Units above the MUE are denied; some MUEs can be exceeded only with appropriate documentation and modifiers where policy allows.

How the amount is calculated

Medicare's Physician Fee Schedule amount is built from three Relative Value Units (RVUs) assigned to the code: physician work, practice expense, and malpractice risk. Each RVU component is adjusted using the Geographic Practice Cost Index (GPCI) values for the specific locality where the service is performed, reflecting differences in local cost of living and practice costs. The locality-adjusted RVUs are summed and multiplied by the annual national conversion factor to produce the dollar allowed amount. Non-facility and facility settings often differ because the practice-expense RVU is typically higher when the service is performed in a physician's office (non-facility) rather than a hospital or ambulatory surgical center (facility), where the facility absorbs certain overhead costs.

RVUs — work 11.63, practice expense 9.66 (non-facility) / 9.66 (facility), malpractice 2.41 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

All figures are estimates only and do not guarantee actual payment.
Medicare typically pays 80% of the allowed amount after the patient meets their Part B deductible; the patient or secondary payer is generally responsible for the remainder.
Modifiers, multiple-procedure reductions, bilateral billing, and other claim-specific factors can change the final payment.
Annual updates to RVUs, GPCIs, and the conversion factor, along with budget-neutrality adjustments and sequestration, may alter amounts from year to year.
Always confirm the applicable rate and any local coverage determinations with your Medicare Administrative Contractor (MAC) before billing or appealing a denial.

Frequently asked

Why does the facility amount differ from the non-facility amount for this code?

The two settings use different practice-expense RVU values because overhead costs are allocated differently depending on whether the procedure is performed in a physician office versus a facility like a hospital or ASC.

Why does the Medicare fee for this code vary by state or county?

Each locality has its own GPCI values for work, practice expense, and malpractice costs, which adjust the national RVUs to reflect local economic conditions before the conversion factor is applied.

Does this amount reflect what the patient will actually owe?

No. Patient responsibility depends on deductible status, secondary insurance, and whether Medicare pays its standard 80% share after the deductible is met.

Can modifiers change the amount shown on this page?

Yes. Modifiers such as those indicating bilateral procedures, reduced services, or multiple-procedure scenarios can increase or decrease the final reimbursed amount relative to the base PFS rate shown here.

More free billing tools: all Medicare fees · fee calculator · denial code decoder

Estimated Medicare Physician Fee Schedule amount. Medicare generally pays 80% after the deductible; actual amounts vary by locality, modifiers, sequestration, and annual updates. Verify with your MAC.